A Leaping Needlefish Stopped His Heart. A Beachside Doctor Saved His Life.

The lineup at Playa Pavones, a legendary left-hand point break on Costa Rica’s southern Pacific coast, is usually a place of rhythmic predictability. But for 42-year-old Brazilian physical educator Fabiano Duarte da Costa, a routine session instantly devolved into a fight for survival when a needlefish vaulted from the water and impaled him in the chest.

Duarte da Costa was simply sitting on his surfboard, waiting for the next set, when the fish struck. He later recalled feeling a massive, blunt impact followed by a sharp, radiating pain before he blacked out and slipped into the water. The elongated, bony beak of the fish had punctured his chest cavity, striking his heart.

What followed was a sequence of miraculous timing and rapid medical logistics. A doctor happened to be on the beach at Pavones and immediately rushed to the water's edge as Duarte da Costa was pulled from the surf. The Brazilian surfer had gone into full cardiac arrest. For roughly two minutes, his heart stopped beating entirely.

Working directly on the sand, the doctor performed emergency resuscitation, successfully restoring Duarte da Costa's pulse. Crucially, lifeguards and first responders made the split-second decision not to remove the fish's beak from his chest, recognizing that it was lodged dangerously close to vital arteries and that extracting it could trigger catastrophic hemorrhaging.[2]

Once stabilized, the massive logistical hurdle of extracting a critical trauma patient from the remote jungle coastline began. Costa Rica’s Ministry of Public Security coordinated an air ambulance transfer from the nearby Coto 47 airstrip to Juan Santamaría International Airport. From there, a Red Cross ambulance rushed him to San Juan de Dios Hospital in the capital city of San José.

Duarte da Costa spent weeks in the intensive care unit. By early summer, he had finally cleared the most critical stages of his recovery and was discharged to recuperate outside the hospital while awaiting final medical clearance to return to Brazil. He publicly credited the Costa Rican public health system, the Red Cross, and the beachside doctor for pulling him back from the brink of death.

While the incident sounds like a freak anomaly, marine medical experts note that needlefish strikes are a documented, if rare, hazard for surfers, kiteboarders, and fishermen. Belonging to the family Belonidae, needlefish are elongated, carnivorous surface-dwellers armed with narrow jaws full of razor-sharp teeth.[1]

When startled by boat motors, predators, or the sudden movement of a surfboard, needlefish can launch themselves out of the water at speeds approaching 40 miles per hour. Because they travel in schools and skip across the surface, a human sitting upright in the water is perfectly positioned in their flight path.[2]

Medical literature indicates that these impacts act like flying daggers. The Surfers Medical Association notes that while many needlefish injuries result in minor puncture wounds or retained jaw fragments, direct strikes to the chest, neck, or eyes can be instantly lethal. Furthermore, the wounds carry a high risk of severe infection from marine bacteria like Vibrio.[1]

Duarte da Costa’s survival is especially poignant given the tragic history of similar encounters. In October 2024, 36-year-old Italian surfer and travel entrepreneur Giulia Manfrini was killed in the Mentawai Islands of Indonesia when a needlefish leaped from the water and struck her in the upper left chest.

Despite the immediate efforts of her partner and local resort staff to rush her to a nearby health center, Manfrini suffered a five-centimeter-deep stab wound and could not be revived. Her death sent shockwaves through the global surfing community, highlighting the absolute unpredictability of the ocean.[2]

Other surfers have narrowly escaped similar fates. In late 2023, Italian surfer Alberto Marcon survived a punctured lung after a needlefish struck him under the armpit in Sumbawa, Indonesia, requiring emergency surgery. Another surfer in Costa Rica suffered a neck strike in December 2025 but ultimately survived.

For Duarte da Costa, the physical scars will eventually heal, but the story of his rescue will remain a testament to the chain of survival. It serves as a stark reminder that in the world's most remote surf breaks, the difference between life and death often comes down to the presence of a bystander who knows CPR.[2]